Because elderly patients often face complex medical problems, they seek care from multiple providers in multiple settings.
Communication among providers as elderly patients transition between settings of care is often lacking.
Do not assume that other providers will handle issues left un-addressed in the hospital.
Often, outpatient providers have no knowledge of what transpired in the hospital, why medicines have been changed, or what additional adjustments are needed.
Treatment plans for post hospital care should be carefully reviewed for accuracy, written down, and communicated to the patient and/or family, and to post-acute care providers.
If you are using the computer to generate this information for the patient and post-hospital providers, make sure that the information on the printed form is accurate and current.
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- Review and write down treatment plans for post hospital care.
- Effectively communicate the treatment plan to the patient, family and post-acute care providers.
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